Hygiene

1
SHUROUQ QADOSE
29/3/2009
Mrs. Mahdia Samaha Kony
05/17/15
Personal hygiene
2
Is the self-care by which people attend to such functions as

bathing, toileting, general body hygiene, and grooming.
It involves care of the skin, hair, nails, teeth, oral and nasal
cavities, eyes, ears, and perineal genital areas.
05/17/15
Factors influencing individual hygienic practices:

3
Culture
Religion
Environment
Developmental level
Health and energy
Personal preference
See table 33-1
05/17/15
Types of hygienic care

4
Early morning care

Morning care
Hour of sleep (HS) or PM
As needed care (prn)
05/17/15
Anatomy of the skin

5
05/17/15
05/17/15
Functions of the Skin

7
The largest organ of the body.

Protection: from injury by preventing the passage of MO,
considered the first line of defense.
Regulation of body temperature
Secretory function: sebum, an oily that softens and lubricates the
hair and skin.
Sensations: nerve receptors are sensitive to pain, temperature,
touch, and pressure.
Absorption of vitamin D.
05/17/15
Nursing Management
8
Assessment, includes:
(a) A nursing history to determine the clients skin care
practices, self-care abilities, and past or current skin
problems
(b) Physical assessment of the skin
(c) Identification of clients at risk for developing skin
impairments
05/17/15
Nursing History
9
Assessment of the clients self-care abilities determines the amount of

nursing assistance and the type of bath best suited for the client.
Important considerations include:
1. The clients balance
2. Activity tolerance
3. Coordination
4. Adequate muscle strength
5. Appropriate joint range of motion
6. Vision
7. The clients preference
8. Cognition and motivation .
See Table 33-2
05/17/15
Physical Assessment
10
Involves inspection
Palpation.
05/17/15
Diagnosing
11
Self- care Deficit diagnoses are used for clients who have
problems performing hygiene care.

Self- care Deficit: Bathing / Hygiene
Self- care Deficit: Dressing/Grooming
Self- care Deficit: Toileting
05/17/15
Etiologies of self-care deficit:

12
Decreased or lack of motivation

Weakness or tiredness
Pain or discomfort
Perceptual or cognitive impairment
Inability to perceive body part
Neuromuscular or musculoskeletal impairments
Medically imposed restriction
Therapeutic procedure restraining mobility
Severe anxiety
Environmental barriers
05/17/15
Planning
13
The nurse and the client and /or family set outcomes for
each nursing diagnosis.
Implementation
The nurse applies the general guidelines for skin care while
providing one of the various types of baths available to
clients.
05/17/15
General guidelines for skin care

14
An intact, healthy skin is the body's first line of defense. Ensure that all
skin care measures prevent injury and irritation.
The degree of the skin protection depends on the general health of the
cells, the amount of subcutaneous tissue, and the dryness of the skin.
Body odors are caused by resident skin bacteria acting on body secretions
Skin sensitivity to irritation and injury varies among individuals.
Agents used for skin care have selective actions and purposes.
Moisture in contact with the skin can result in increased bacterial growth
and irritation.
05/17/15
Bathing
15
Bathing removes accumulated oil, perspiration, dead skin cells

and some bacteria.
Two categories of baths are given to clients:
Cleaning baths are given for hygiene purposes and include:
Complete bed bath
Self-help bed bath
Partial bath
Bag bath
Tub bath
Shower
05/17/15
16
05/17/15
17
05/17/15
18
05/17/15
Therapeutic bath
19
Baths are given for physical effects:

To soothe irritated skin
To treat an area such as perineum
Medication may be placed in the water.
Perineal-genital care is also referred to as perineal care or
pericare.
05/17/15
Nursing Management
20
Feet
The feet are essential for ambulation and merit attention even
when people are confined to bed.
Assessing it includes the following
Nursing Health History of:
(a)Normal nail and foot practices
(b)Type of foot wear worn
(c)Self-care abilities
(d)Presence of risk factors for foot problems
(e)Any foot discomfort
(f)Any perceived problems with foot mobility.
05/17/15
Physical Assessment
21
Each foot and toe is inspected for:

Shape
Size
Presence of lesions
Palpated to:
Assess areas of tenderness
Edema
Circulatory status.
Normally, the toes are straight and flat.
05/17/15
Common foot problems include:22
Callus: is a thickened portion of epidermis, a mass of

keratotic material.
Most calluses are painless and flat and are found on the
bottom or side of the foot over a bony prominence
Usually caused by pressure from shoes.
Corn: is a keratosis caused by friction and pressure from a
shoe. It commonly occurs on the forth or fifth toe, usually
on a bony prominence such as a joint.
05/17/15
23
05/17/15
Unpleasant odors: occur as a result of perspiration and its
interaction of microorganisms.
Planter warts: appear on the sole of the foot.
Fissures: or deep grooves frequently occur between the toes as a
result of dryness and cracking of the skin.
05/17/15
Athletes foot or tinea pedis (ringworm of the foot) it is caused
by a fungus.
The symptoms are scaling and cracking of the skin, particularly
between the toes.
Sometimes small blisters form, containing a thin fluid.
05/17/15
Ingrown toenail: the growing inward of the nail into the
soft tissues around it, most often results from improper

nail trimming.
05/17/15
Clients at Risk
27
Diabetes
Peripheral vascular disease
Are prone to infection if skin breakage occurs because of
reduced peripheral circulation to the feet, clients with.
05/17/15
Diagnosing
28
*Self care deficit: Hygiene (foot care) R/T

- Visual impairment
- Impaired hand coordination
* Risk for impaired skin integrity R/T
- Poorly fitting shoes
* Risk for infection R/T
- Impaired skin integrity (trauma, corn)
- Deficient nail or foot care
* Deficient knowledge (diabetic foot care) R/T
- Lack of teaching/learning activities about diabetic foot care
- Newly established medical diagnosis (diabetes)
05/17/15
Planning
29
(a) identifying nursing interventions that will help the
client maintain or restore healthy foot care practices

(b) establishing desired outcomes for each client.
Implementation
In Skill lab
05/17/15
Nails
Nursing Management
30
Assessing
Health history: the nurse explores:
The clients usual nail care practices
Self care abilities
Any problems associated with them.
Physical assessment: inspection of the nails (shape and
texture, nail bed color, and tissues surrounding the nails).
05/17/15
Diagnosing
31
*Self care Deficit: Grooming related to impaired vision

*Risk for infection around the nail bed related to
- Impaired skin integrity of cuticles
- Altered peripheral circulation
05/17/15
Planning
32
The nurse identifies measures that will assist the client to

develop or maintain healthy nail care practices.
Implementation
In Skill lab
05/17/15
Evaluation
33
Examples of desired outcomes:

The client being able to:
Demonstrate healthy nail care practices as shown by:
Clean,
short nails with smooth edges

Intact cuticles and hydrated surrounding skin
Describe factors contributing to the nail problems
Describe preventive interventions for the specific nail
problem
Demonstrate nail care as instructed
05/17/15
Mouth
34
Each tooth has three parts: the crown, the root, and the pulp
cavity.
Nursing Management
Assessing
Assessment of the clients mouth and hygiene practices
includes:Nursing history
The nurse obtains data about the clients oral hygiene
practices, including dental visits, self care abilities, and
past or current mouth problems.
05/17/15
Physical assessment
35
Most common problems affect the teeth.

Tarter is a visible, hard deposit of plaque and dead bacteria
that forms at the gum lines.
Gingivitis "red, swollen gingival", bleeding, receding gum
lines, and the formation of pockets between the teeth and
gums.
Pyorrhea; the teeth are loose and pus is evident when the
gums are pressed.
05/17/15
36
05/17/15
37
05/17/15
38
Plaque is an invisible soft film that adheres to the enamel surface

of teeth , it consist of bacteria, molecules of saliva.
05/17/15
Identifying Clients at risk

39
Clients who lack of knowledge

Clients who has inability to maintain oral hygiene:
1. Seriously ill clients.
2. Confused clients.
3. Comatose clients.
4. Depressed clients.
5. Dehydrated clients.
6. Clients with nasogastric tubes
7. Clients receiving oxygen
8. Clients who have had oral or jaw surgery must have meticulous
oral hygiene care to prevent the development of infections.

05/17/15
Identifying Clients at risk

40
Clients in long-term care settings.

A dry mouth can be aggravated by:
1. Poor fluid intake
2. Heavy smoking
3. Alcohol use
4. High salt intake
5. Anxiety
6. Medications.
Clients who are receiving or having radiation treatments to the head
and neck may have permanent damage to salivary glands
05/17/15
Diagnosing
41
*Self care deficit: oral hygiene will be used for clients

unable to perform oral care independently.
*Impaired oral mucous membrane related to
- Ineffective oral hygiene
- Physical injury or drying effect (mouth breathing, oxygen
therapy)
05/17/15
Planning
42
Specific detailed nursing activities taken by the nurse may include

the following:
Monitor every shift to dryness of the oral mucosa
Monitor for signs and symptoms of glossitis" inflammation of the
tongue" and stomatitis" inflammation of the mouth.
Assist dependent clients with oral care.
Provide special oral hygiene for clients who are debilitated,
unconscious, or have lesions of the mucous membrane or other
oral tissues.
05/17/15
43
Teach clients about good oral hygiene practices and other
measures to prevent tooth decay.

Reinforce oral hygiene regimen as part of discharge
teaching.
05/17/15
Implementation
44
Good oral hygiene includes daily stimulation of the gums,

brushing, flushing of the mouth.
Promoting Oral Health through the Life Span
Infant and Toddler
The
nurse should give parents the following

instructions to promote and maintain dental
health:
Beginning at about 18 months of age, brush
the child's teeth with a soft toothbrush
05/17/15
Infant and Toddler

45
Give a fluoride supplement daily or as recommended

Schedule an initial dental visit for the child at about
2-3 years of age.
Some dentists recommend an inspection type of visit
when the child is about 18 months old to provide an
early pleasant introduction to the dental examination.
Seek professional dental attention for any problem
such as discoloring of the teeth.
05/17/15
46
05/17/15
47
Preschools and School-Age Children

Adolescents and Adults
Assisting clients with oral care
Clients with special oral hygiene needs
05/17/15
Caring for artificial dentures

48
05/17/15
49
Brushing and flossing the teeth
05/17/15
50
A foam Swab
05/17/15
Hair
51
Developmental Variations
Newborn may have lanugo" fine hair on the body of the
fetus.
In older adults the hair is generally thinner, grows more
slowly and loses its color as a result of aging.
05/17/15
Nursing Management
52
Assessing
Nursing history
The nurse collect data about usual hair care, self care
abilities, history of hair or scalp problems.
Physical assessment
Problems include
05/17/15
Hairproblems
53
Scabies;
Is a contagious skin infestation by the itch mite.
Treatment involves through cleansing of the body with
soap and water to remove scales and debris from crusts,

and then an application of the scabicide lotion.
All bed linens and clothing should be washed in very hot
or boiling water.
05/17/15
Hairproblems
54
Hirsutism; the growth of excessive body hair. The cause is

not always known.
Dandruff; Often accompanied by itching.
Pediculosis (Lice)
Hair loss
05/17/15
55
05/17/15
Nursing diagnosing related to hair hygiene

and hair and scalp56problems include:
*Self care deficit: Grooming relatedto
-Activityintolerance
-Immobility
-Paininupperextremities
-Alteredlevelofconsciousness
-Lackofmotivationassociatedwithdepression
05/17/15

and hair and scalp problems include:
57
Self care deficit: Grooming relatedto

-Activityintolerance
-Immobility
-Paininupperextremities
-Alteredlevelofconsciousness
-Lackofmotivationassociatedwithdepression
05/17/15

and hair and scalp problems include:
58
Impaired skin integrityrelatedto:
-Scalplaceration
- Insectbite
Risk for infection relatedto
-Scalplaceration
-Insectbite
Disturbed body imagerelatedtoalopecia
05/17/15
Implementing
59
Brushing and Combing Hair

Shampooing the hair.
Beard and mustache care
05/17/15
Nursing Management of the eyes

60
Assessing
Assessmentoftheclientseyesincludes:-
- Nursing health history
Thenurseobtainsdataabouttheclientseyeglassesor
contactlenses,recentexaminationbyan
ophthalmologist,andanyhistoryofeyeproblems.
- Physical assessment
Inspectionoftheexternaleyestructures
05/17/15
Nursing diagnosing related to eye problems

may include:
61
Self care deficit (insertion and removal contact lens,

cleaning)relatedto:
-DeficientKnowledge
-Impairedvisionassociatedwithcataracts
05/17/15
Nursing diagnosing related to eye problems

may include:
62
Risk for infection related to

- Improper contact lens hygiene
- Accumulation of secretions on eyelids
Risk for injury related to
- Prolonged wearing of contact lenses
- Absence of blink reflex associated with unconsciousness
05/17/15
Implementing
63
Nursing activities may include:Eye Care; dried secretions that have accumulated on the
lashes need to be softened and wiped away.
Eyeglass Care
Removing Contact Lenses
Inserting Contact Lenses
05/17/15
General Eye Care

64
Avoid home remedies for eye problems.

If dirt or dust gets into the eyes, clean them copiously with
clean, tepid water as an emergency treatment.

Take measures to guard against eyestrain and to protect
exertion.
Schedule regular eye examinations, particularly after age 40
to detect problems such as cataracts.

05/17/15
Evaluation
65
Conjunctiva and sclera free of inflammation

Eyelids free of secretions
No tearing
No eye discomfort
Demonstrate appropriate methods of caring
for contact lenses
Describe interventions to prevent eye injury
and infection
05/17/15
66
05/17/15
EARS
67
Normal ears require minimal hygiene. Clients who have

excessive earwax and dependent clients who have hearing
aids may require assistance from the nurse.
Cleaning the Ears
Care of Hearing Aids
05/17/15
NOSE
Nurses usually need not provide
special care for the nose,
68
because clients can ordinarily clear nasal secretions by
blowing gently into a soft tissue.
Supporting A Hygienic Environment
When providing a comfortable environment it is
important to consider the clients age, severity of illness,
and level of activity
Room Temperature
Ventilation.
Noise
05/17/15
Hospital Beds
Commonly used bed positions
69
- Flat
- Fowlers position (semisitting position in which head of bed is
raised to angle of at least 45.)
- Semi- Fowlers position (head of bed is raised only to 30 angle.)
- Trendelenburgs position (head of bed is lowered and the foot
raised in a straight)
- Reverse Trendelenburgs position (head of bed raised and the
foot lowered).
05/17/15
70
05/17/15
71
05/17/15
72
05/17/15

Hygiene

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Hygiene

Uploaded by

Copyright:

Available Formats

1

Mrs. Mahdia Samaha Kony

Is the self-care by which people attend to such functions as

Mrs. Mahdia Samaha Kony

Factors influencing individual hygienic practices:

See table 33-1

Mrs. Mahdia Samaha Kony

Types of hygienic care

Early morning care

Mrs. Mahdia Samaha Kony

Anatomy of the skin

Mrs. Mahdia Samaha Kony

Mrs. Mahdia Samaha Kony

Functions of the Skin

The largest organ of the body.

Mrs. Mahdia Samaha Kony

Mrs. Mahdia Samaha Kony

Assessment of the clients self-care abilities determines the amount of

Mrs. Mahdia Samaha Kony

problems performing hygiene care.

Mrs. Mahdia Samaha Kony

Etiologies of self-care deficit:

Decreased or lack of motivation

Mrs. Mahdia Samaha Kony

General guidelines for skin care

Skin sensitivity to irritation and injury varies among individuals.

Mrs. Mahdia Samaha Kony

Bathing removes accumulated oil, perspiration, dead skin cells

Mrs. Mahdia Samaha Kony

Mrs. Mahdia Samaha Kony

Mrs. Mahdia Samaha Kony

Baths are given for physical effects:

Mrs. Mahdia Samaha Kony

Each foot and toe is inspected for:

Common foot problems include:22

Callus: is a thickened portion of epidermis, a mass of

Mrs. Mahdia Samaha Kony

Common foot problems include:24

Unpleasant odors: occur as a result of perspiration and its

Mrs. Mahdia Samaha Kony

Common foot problems include:25

Athletes foot or tinea pedis (ringworm of the foot) it is caused

Mrs. Mahdia Samaha Kony

Common foot problems include:26

Ingrown toenail: the growing inward of the nail into the

soft tissues around it, most often results from improper

Mrs. Mahdia Samaha Kony

Mrs. Mahdia Samaha Kony

*Self care deficit: Hygiene (foot care) R/T

(a) identifying nursing interventions that will help the

client maintain or restore healthy foot care practices

Mrs. Mahdia Samaha Kony

texture, nail bed color, and tissues surrounding the nails).

Mrs. Mahdia Samaha Kony

*Self care Deficit: Grooming related to impaired vision

Mrs. Mahdia Samaha Kony

The nurse identifies measures that will assist the client to

Mrs. Mahdia Samaha Kony

Examples of desired outcomes:

short nails with smooth edges

Most common problems affect the teeth.

Mrs. Mahdia Samaha Kony